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进食后人体对麻醉剂的摄取、排泄及血液溶解度增加。

Increase in anesthetic uptake, excretion, and blood solubility in man after eating.

作者信息

Munson E S, Eger E I, Tham M K, Embro W J

出版信息

Anesth Analg. 1978 Mar-Apr;57(2):224-31. doi: 10.1213/00000539-197803000-00013.

Abstract

Blood-gas partition coefficients of N2O, enflurane, halothane, methoxyflurane, and isoflurane were measured on blood samples from 12 healthy male volunteers before and after eating. The solubility values determined while volunteers fasted substantiate previously reported blood-gas partition coefficients for enflurane, isoflurane, and halothane. Solubility values for methoxyflurane and N2O were slightly greater and smaller, respectively, than accepted values. The uptake and excretion of N2O, enflurane, halothane, and methoxyflurane also were measured in 6 of these subjects in the fasted and postprandial states. Subjects breathed a constant, inspired mixture containing trace concentrations of all 4 gases. Eating increased blood solubility by 17 to 24 percent for all agents except N2O. Accordingly, the rates of rise of the end-tidal enflurane, halothane, and methoxyflurane concentrations were 7 to 8 percent below control, and the rates of anesthetic uptake increased 20 to 23 percent. Simulation studies showed that the increased ventilation induced by eating opposed and, therfore, minimized the impact of increased blood solubility and cardiac output on the rate of end-tidal anesthetic rise. Changes in blood solubility did not correlate with levels of plasma triglycerides and cholesterol.

摘要

对12名健康男性志愿者进食前后采集的血样,测量了氧化亚氮、恩氟烷、氟烷、甲氧氟烷和异氟烷的血气分配系数。在志愿者禁食期间测定的溶解度值证实了先前报道的恩氟烷、异氟烷和氟烷的血气分配系数。甲氧氟烷和氧化亚氮的溶解度值分别略高于和低于公认值。还对其中6名受试者在禁食和进食后状态下的氧化亚氮、恩氟烷、氟烷和甲氧氟烷的摄取和排泄情况进行了测量。受试者呼吸含所有4种气体微量浓度的恒定吸入混合气。进食使除氧化亚氮外的所有药物的血液溶解度提高了17%至24%。因此,呼气末恩氟烷、氟烷和甲氧氟烷浓度的上升速率比对照低7%至8%,麻醉药摄取速率提高了20%至23%。模拟研究表明,进食引起的通气增加起到了对抗作用,因此将血液溶解度和心输出量增加对呼气末麻醉药上升速率的影响降至最低。血液溶解度的变化与血浆甘油三酯和胆固醇水平无关。

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